Expression And Significance Of PCNA And Bcl-2 In Bile Duct Epithelial Cells In Patients With Hepatolithiasis

Objective: Hepatolithiasis is a risk factor for cholangiocarcinoma. However, it is difficult to identify early cholangiocarcinoma that occurs as a complication of hepatolithiasis. To investigate the relationship between hepatolithiasis and cholangiocarcinoma, the expression of PCNA and Bcl-2 were studied in normal biliary epithelium, bile duct epithelial cells in patients with hepatolithiasis and cholangiocarcinoma. Methods: The expression of PCNA and Bcl-2 were detected in 49 cases of hepatolithiasis paraffin specimen using S-P immunohistochemical staining, 16 cases of cholangiocarcinoma and 10 cases of normal biliary epithelium paraffin specimen were collected as control. Aditionally, the experimental data were analysed by statistic.Results:1. Atypical epithelial hyperplasia was found in 7 of 49 cases (14.3%) with hepatolithiasis, the bile ducts demonstrated luminal dilation and pronounced fibrosis of ductal walls and periductal tissues histologically. There was inflammatory cell infiltration in the ductal walls and periductal tissue coinciding with the features of chronic proliferative cholangitis. Well-differentiated, mediated-differentiated and poorly-differentiated adenocarcinoma were found in 10 of 16 cases(62.5%), 4 of 16 cases(25%) and 2 of 16 cases(12.5%) in cholangiocarcinoma respectively.2. The expression of PCNA and Bcl-2 were significant difference among the normal bile ducts (14. 24 + 4.49, 4. 14?.65), bile duct epithelial hyperplasia. (29. 78?. 41, 9.83 + 3.80), atypical epithelial hyperplasia(52.04?1.35, 30.06+11.05 ) and cholangiocarcinoma (71.50+14.31, 44. 29 + 12. 48) (P<0. 05). The expression of PCNA and Bcl-2 were increased by degrees from normal bile ducts to bile duct epithelial hyperplasia , to atypical hyperplasia , and finally to cholangiocarcinoma.3. There is not difference about the expression of PCNA between atypical epithelialhyperplasia(52. 04+11. 35) and cholangiocarcinoma(66. 20 + 6. 96) (P>0. 05).4. The expression of PCNA is significantly difference in all grade of differentiation of cholangiocarcinoma(P<0.05), and it shows that the expression of PCNA is increased by degrees from well-differentiated (68. 55 + 7. 75) to mediated-differentiated(81. 63?. 52) and finally to poorly-differentiated group (88. 73?. 71).5. The expression of PCNA in hepatolithiasis patients with jaundice was higher than those without jaundice(P<0.05).6. The expression of Bcl-2 in well-differentiated group(53. 00 + 4. 72) was higher than thoese in mediated-differentiated(29.07?.58) and poorly-differentiated group(31. 22 + 4. 10) (P<0. 05).conclusion:. 1. Hepatolithiasis is a risk factor for cholangiocarcinoma. The development sequence of cholangiocarcinoma developing is from normal bile ducts to atypical epithelial hyperplasia , and to cholangiocarcinoma finally. And atypical epithelial hyperplasia is a precancerous lesion.2. Hepatolithiasis is a risk factor for cholangiocarcinoma, especially in the patient with jaundice.3. The expression of PCNA and Bcl-2 might be associated with the-4-differentiation and the prognosis of cholangiocarcinoma.